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General NPI Number Information
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NPI Number | 1043204811
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Entity Type | Organization
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Legal Business Name | FAMILY PRACTICE & COUNSELING SERVICES NETWORK
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 4700 WISSAHICKON AVE BOX 110, SUITE 119, BLDG. D
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4248
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Country | US
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Telephone | 215-843-9720
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Fax | 215-843-7313
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Provider Business Mailing Address
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Address Line | 4700 WISSAHICKON AVE BOX 110, SUITE 118, BLDG. D
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4248
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Country | US
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Telephone | 267-597-3600
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Fax | 267-597-3622
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Authorized Official
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Title or Position | CEO
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Name | EMILY NICHOLS
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Credential |
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Telephone | 267-597-3604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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